Healthcare Provider Details

I. General information

NPI: 1699951772
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W MCLAIN ST
SEYMOUR TX
76380-2537
US

IV. Provider business mailing address

269 RENNER PKWY
RICHARDSON TX
75080-1316
US

V. Phone/Fax

Practice location:
  • Phone: 940-888-5586
  • Fax: 940-888-5741
Mailing address:
  • Phone: 972-840-7360
  • Fax: 972-792-6739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number007336
License Number StateTX

VIII. Authorized Official

Name: JULIE RYON
Title or Position: DIRECTOR
Credential:
Phone: 972-840-7360